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tv   2 Weeks to a Younger Brain  CSPAN  February 5, 2017 3:52pm-4:38pm EST

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[applause] and i want you to understand the wisdom that is out there on these matters. there is only one person on earth who can determine how happy you are. that is you. thank you so much. [applause] thank you very much. thank you, thank you. thank you. [applause] i will be signing books. thank you all very very much. thank you. [inaudible conversations]
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please take your seats we are about to begin. [inaudible conversations] >> ladies and gentlemen, doctor gary small. [applause] >> thank you. michael, how are you? i have got my outside voice. fantastic. welcome, it is such a beautiful day. we have got snowcapped mountains, we have the desert, clean air and you have got a bunch of people who are just settling down. you're interested in what we are going to talk about today. i want to thank you for spending time in coming to hear what i have to say. how many of you would like to
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live to be 100 or beyond? [inaudible] okay settle down. how about living well and healthy two 100 and beyond? there you go. i'm going to tell you how to do it. but first meet madame ãshe lived in the south of france. she was physically active. mentally active. born 1875. died 1997. can anyone do the math? 122. you pass your first cognitive test. give yourselves a big hand. what was extraordinary about
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this woman, was when she died she did not have dementia. she did not have alzheimer's. she was mentally clear. they did an autopsy in her brain and it was the brain of a healthy 80-year-old. so there is this connection between how we behave if you're in the south of france you will eat the mediterranean diet.it is good for your heart and brain. stay physically active. how we behave and how our brains age now, madame calmet was also an astute businesswoman. at the age of 94, she sold to a businessman who agreed to let her live there for the rest of her life. he died 10 years later. [laughter] this is
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extraordinary because we do not all live that long.and in fact, in the 19th century, life expectancy was much shorter. but we have other examples. i've extreme longevity. pockets of the world, these so-called blue zones where people live to 100 or beyond. they are centenarians. places like sardinia italy, okinawa japan, or not far from here loma linda california. and in all of these areas, there is a tendency to share these kinds of healthy brain habits. there are strong social ties, people eat a healthy diet and their physically active. and this brings us to the formula for successful brain aging. physical exercise, mental stimulation, social interactions.
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other activities that manage stress. and of course, let's see, what was the other one? i will get to that later. but trust me, there is a formula. there is a book i've written about this and i encourage you to get so you do not forget. now, this brings us to the whole question of brain health. people think about brain health, they tend to think about memory. no memory is important. without our memory we have no past, we cannot plan for the future. and we cannot appreciate the present. so clearly, memory defines who we are but brain health is more than just memory. very important aspect of brain health is being able to think and reason and understand what you have a steady mood. if you can achieve your brain health, and you're going to be able to remember and think
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about all of those decisions you need to make every day to keep your brain healthy. it is critically important. one aspect of brain health you may not be aware of, is inflammation. now inflammation we know is a normal physiological process. that helps us fight off infection, repair damage. if you sprain an ankle it gets warm and hot and swollen. that means your inflammatory cells are doing their job. the problem is, as we age we get too much inflammation. and that affects our brain. we have heightened inflammation in the brain and those inflammatory cells actually attack normal cells. we can do something about it. in fact, there are many strategies. we will be talking about them today that are anti-inflammatory and help us fight inflammation.get a good night sleep, how do you feel after a good night of sleep?
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you feel fantastic having your mind clear, more energy, fewer aches and pains. because of the anti-inflammatory aspect of sleep. your diet can affect your inflammation. eating fish as an anti-inflammatory strategy. one of my best or favorite is physical exercise, critically important. so, you know the other side of brain health, the flipside of it of course is alzheimer's disease. we are all very frightened of this. and we read about it a lot in the news, there are celebrities who have been affected, new headlines every day, it is very hard to keep up with it. when they we are saying take vitamin e, the next day we are saying don't take vitamin e. so it is confusing not just for the public but to the scientists. with all of this information. and if we can keep our brains healthy, we can fight off
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alzheimer's disease. one of the, hydration is good for your brain by the way. one of the biggest questions i get when i give a talk is what is the difference between dementia and alzheimer's? and i will try to explain the fearless start with alzheimer's. it was first described in 1906. by a doctor.and the patient got confused very quickly and died at age 55. he did an autopsy of her brain. for the first time showed abnormal protein deposits called ãyou can see them appear on the slide. their tiny little proteins that actually attack areas of the brain that define brain health. this is where thinking and memory is controlled.
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the medical community did not think much of this because the woman was in middle age, it was very rare to see this. but in the late 1960s, scientists study so-called senility.they looked inside the brain of these senile people and they saw the same plaque and tangles. so now we have late onset alzheimer's and it was quite frightening to the public because now there is an epidemic of alzheimer's disease. because we are all living longer. now that was frightening but, i will show you why we can do things about it. here we see two brains. one is an alzheimer brain and the other is a normal brain. you can see the alzheimer brain is smaller. that is activate, it shrunk. and you can see the insects show you whether high concentrations of the tangles and the plaque in the atrophied
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alzheimer brain. but if you look at this normal brain, if you look closely you can see an occasional plaque and an occasional single. but what we are learning is that alzheimer's disease can build up in all of our brains. many years before we even realize. we have learned that during modern technology. at ucla, we have been using brain imaging tools like ãor pet scanning. to understand and see how alzheimer's builds up in the brain years ago invented the first brain pet scan to be able to provide a measure of the physical evidence of alzheimer's disease in living people. here we see an animation 20 scans put together and you see
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how the brain gets more yellow and eventually more red, that shows you where the alzheimer's is building up in the brain. and as there is more alzheimer's the memory score gets worse. and these are people have traces of the plaques and tangles. but will not symptoms for 10 or 20 years. now when i tell this to people usually they freak out. this a oh my gosh i have alzheimer's building up in the brain. i see the positive side. and that is that with these kinds of tools, we can identify problems very early. so we can do things about it before there are chances of symptoms. now, i talked about, just for a moment the formula for keeping your brain young. some of the things we can do. i will emphasize that today. genetics comes into play to some extent. there are very rare genes called mutation that actually
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cause the disease. it is extremely rare and it occurs in families where have relatives get the disease often in middle age. now that is important for our research to try and understand how to help people. but for most of us, those kinds of genetic causes are not an issue. there are genetic risks and the one that has been studied the most is called ã1/5 list has this genetic risk. it means that we are more likely to get alzheimer's at an earlier age. but it is not an absolute. so we do not recommend genetic testing for the average person. because lots of people never get alzheimer's. and lots of people without it did get alzheimer's. so it is just a risk factor. not an absolute. and it turns out that studies looking at genetics versus nongenetic factors so that for
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the average person, genetics is not as important as lifestyle choices and nongenetic factors. now if you look at cognitive health versus age, pc it is a downhill slope. [laughter] we have some control over it. doctors and scientists have come up with different stages of decline. and the first one we call normal aging. this is where we are forgetting what we put our keys or i will walk into the kitchen and say why did i walk into the kitchen? i am sure we have all experienced these things. now, generally we joke about it and it does not progress to rapidly. it can be relatively stable with these kinds of categorizations or categorizations tend to be confusing. i have come up with my own scientific graph based on my own experience. it helps us understand the
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aging brain. so we have about one third of the time we are sleeping. about one third of the time we are working. and one third of the time what are we doing? oh yes, we are looking for things we just had a moment ago. i find this a little moment ago. but if we go back to the more conventional approach, if normal aging worsens, the experience is mild -- this is where we are able to compensate.we are able to fill in and function independently. when the compensation breaks down, that is what we call dementia. that is where someone's memory is so bad that they need help from others. they no longer are independent. there is a lot of causes for dementia. alzheimer's disease, what i described a moment ago is the
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most common cause. about two thirds of dementia are caused by alzheimer's disease. but you could have a depression and it could look like dementia. and that can be treated. or you can have a medication side effect or thyroid imbalance. so it is very important, anybody who is concerned about their memory should check in with their dr. to find out what's going on. now, we know the common memory complaints, right five names and faces, where you put things, forgetting an appointment or plan. it can be very annoying. you know the word you blurted out later a different looksee like you're crazy. it turns out that we have developed methods to compensate for all of these problems. 85 percent of people to complain about age-related memory issues complain about names and faces. that is a very annoying but i will share with you today some of the strategies we developed that are very easy and will
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very quickly help you compensate for these normal issues. now, i wanted to just give you another example of successful brain aging. this is a photograph that my wife took of myself and her 104-year-old grandmother. now in the interest of transparency, i just want to disclose those not injecting myself with anabolic steroids. and by the way, this is before i started painting my hair white. [laughter] grandma was very short and she was very feisty. a very spirited woman. when she was on the phone she would talk to relatives and family all the time. that spoke to her social engagement. she was in an apartment in new york where there was no elevators. she had lots of physical exercise. so she was practicing the brain healthy lifestyle. and she was mentally very clear.
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throughout her life. but every time we visited, i would be concerned knowing her age as a risk factor for alzheimer's, i would want to do a mental status. but she was too proud to let me do that. so i remember this visit, i said, grandma how old are you now and five and she said shut up. [laughter] so she passed her mental status exam very well. unfortunately, not all of us do that well. we do not live to 104 122, mentally clear and we have this downhill slope. what our goal is, to identify problems early, intervene early so we can slow that down. unfortunately, doctors tend to do too little too late. we wait until somebody already has dementia. we can help them, there are medicines and other strategies to help but it is easier to
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protect the healthy brain than to try and repair damage once that damage is extensive. so if you take someone who has alzheimer's disease and to give them is placebo or sugar pill, is not going to help. they're going to go down a certain rate. now we have medicines that are close symptomatic drugs. you see them advertise on television now. have been around for quite some time. and they do help to some extent. they do not cure the disease, to provide temporary relief. often they can keep patients in the community longer because you can stabilize the symptoms. and that is helpful. but what we are searching for right now and the research is what is called a disease modifying treatment. so you can slow down that slope of decline. now, the way of looking at it is, if you had pneumonia and symptomatic treatment would be an aspirin. he would feel better but it would not get rid of the pneumonia.
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you need to take an antibiotic which is the disease modifying treatment. unfortunately, all of the research that has been done so far for that kind of treatment, that research has failed. there've been a lot of studies looking at infusions, new pills, we are starting, i'm optimistic that ucla we are starting a new study with focused ultrasounds. we take that diagnostic tool and take those waves and focus them on memory centers of the brain to see if we can stimulate some of the neural connections.this research is very important. we have to continue it and we are in the midst of it and i will describe some of what we have done. but while we are waiting for science to catch up, there is a lot we can do. to keep our brains healthy.i want to focus on that in just a moment. here is just an example of the kind of research we have been doing and i've been emphasizing how important it is to control inflammation. a few years ago thanks to the
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help of the national institutes of health, we did a study where we look at anti-inflammatory drug and people middle-aged and older who were having normal memory complaints. and we found that after 18 months, those who took the anti-inflammatory drugs actually had better memory. when he did brain pet scans are so there was better brain function in front part of the brain. the thinking brain. that is able to understand and solve problems. so this was a positive study. it was controlled with placebo. was he had a group taking a sugar coat. the problem is, that it was a small study. in these drugs have side effects. and other studies have found that if you give these drugs to people who already have dementia, actually have the opposite effect. it can accelerate. so there's a tipping point when certain interventions help or hinder brain health.
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so we have been trying to explore other safer ways to dampen inflammation. now, by the way this is what i would like to be doing when i am 100. but i probably will not be doing it because i've never ã as i said, you do not need the polevaulting gene. there are nongenetic strategies that make the difference. probably number one, if you do nothing else after today, make sure you exercise every day. not to become a triathlete, one study found that 20 minutes of walking can lower your risk for alzheimer's. if you cannot walk, your lower extremities are bothering you, go swimming or do anything to get your heart pumping oxygen and nutrients to your brain cells. the exercise will increase the circulation of endorphins.
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which causes the runner's high. it improves your mood. it also gives your body to secrete chemicals that get your brain cells to sprout branches and communicate more effectively. so exercise is tremendously important. we've done studies, others have done studies. in fact, a lot of them were done at the university of illinois. this is an example of one study where they had older people start walking every day a bit. they had a control that justin stretching and tony. you can see in this graph, we have the size of the campus, this is a very important memory center of the brain. underneath the temples. and you can see after six months, and after a year the campus keeps growing in size. critically important. it turns out a bigger brain is a better brain. so somebody called you a fat head is actually a compliment. [laughter] so what about brain fitness and
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brain exercise? we hear a lot about that and how we can build the muscle is very important. if you speak several languages have a low risk for all summers. or people who attend college and graduate from college have a lower risk. we know that is definitely true about ucla. [laughter] we are still tallying the results of ufc. by the way did go to their medical school. if you never went to college what you are doing here the book festival, lifelong learning. educating yourself.that protects your brain from alzheimer's. so anything that you like to do, games, conversations, that is probably going to be good for your brain. but you know we are in an age right now where everything is high-tech. we have all of these devices. people come to my office and is
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a doctor small, i can't remember phone numbers anymore. i'm very frightened. and i will tell them look, don't worry about your memory because your memory will be worse and pick and choose what you commit to memory. to get into this whole area of the pros and cons of the technology. and there are pros and their archons. you know it is a challenge for older people. we know that they tend to use computers and devices less than younger people. although there are no starting to engage in it. but they still like old-school kinds of devices. [laughter] know i should and i love it so much it was falling apart and attached it together with scotch tape as long as i can have it. there is debate in the media. is google making us stupid? if there are digital natives in the room i want to point out that stupid is misspelled.
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so we were curious about this. to understand it better. at ucla we did a study called your brain on google. wanted to understand what the brain looks like when searching online. i was particularly interested to see what the brain look like the first time someone searches online. and i had to get some volunteers for this. quickly linda cannot recruit them online. [laughter] i found people exist. congratulations you are the last person to get an email account. he succeeded. we recruited a lot in the libraries. and what we did, we put them into the mri scanner. we had the more special goggles and we could show them images that look like online sites. and they had a little mouse at their side so they could search online in the scanner. so we can measure their brain activity from moment to moment. i will cut to the chase. the colored areas show you where the brain was engaged.
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this first group, these were people who were internet nacve. they were searching online for the first time.you see, there is some red and important areas but there is not a whole lot. we had the people with internet experience search online. their brains were having a party. it was more than twofold increase activation in the brain. so just searching online can be a form of brain exercise. we think it works like this. this u-shaped curve, it is turned upside down. this works in any scientific experiment by the way. we thank if you have brain activation versus time anytime we are confronted with a unfamiliar task we are confused. but once we understand it would figure out a strategy, that's when we engage our brain cells. once we get good at it we get
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more efficient and you see less brain activity. now, in the debate about technology, there has been a lot of scientists looked at the potential upside and there is a group in the bay area and has been studying different brain games for really videogames. here's one that involves keeping a racecar on a winding road while informative or distracting signs pop up. so it really teaches multitasking. it turns out, if they have 70 or 80-year-olds play the scamper we go to that individual can multitask as well as a 20-year-old who has never played the game. so it is really quite remarkable how much we can do. and there are other studies showing the various brain games and how they improve brain activity. in my latest book i have a whole section on this with resources if you are interested.very interestingly they found that surgeons who
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play video games make fewer errors in the operating room. so the next time you have to have surgery, forget about asking where they went to college or medical school. how many hours of world of warcraft do play a week? there you are. so we study these approaches systematically. lifestyle approaches and we find they make a difference. we have had to eat studies, six-week studies. with find that subjective objects of mary improve and we do brain scans and we see there is improvement in the frontal lobe of the brain. here is a study using mris. in the upper images, they show you what we call the brain stress test. so during the scan we give this woman a memory task. and you see there is a lot of activity. a lot of red. her brain was working really hard to remember. we put her on the two week program that we described in the book.
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and we repeated the experiment. very little activity. what that tells us, that she is not working as hard. when we did the memory test, her memory scores improved by 200 percent. so it is a bit like going to the gym we start lifting weight, your sore and if you train, you can lift more weight and exert less energy. we can do the same thing to improve our brain. now, we've developed some very civil memory techniques. look at snap connect is one of them. look is one to focus her attention. the biggest reason people do not remember it because they're simply destructive.snap is a reminder to take a mental snapshot of what you want to remember later. this builds on our brains and nate abilities. involved over many years.
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and finally connect is a way of linking up those mental snapshots so that they have meaning. if you can make something meaningful, it will be memorable. let's see how it works. how many of us have forgotten where we parked our car? quite a few. it is disconcerting to say the least. so you can use look snap connect for everyday memory challenges. by finding your car. so we have a lot 3b and when i parked there is the three large bees hovering over my car. if i parked just below it and lot to be i see william shakespeare on my car designed to be or not to be. so does that mean that my car is not to be or maybe that is not the best example. but these kinds of techniques really transfer to everyday life. so do you remember her name? okay. so some people say grandma some people said all week.
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and so, he said grandma because it was part of the story. it had meaning. but you can give her face meaning to them by looking at her for a moment saying what she has all of colored skin. ali, olive. or harry, turns out he has a lot of hair. i want you to meet lisa, she is very pretty subtle mona lisa smile. and, you meet mrs. bangle. that's easy, she has banks. and then she tell you she is attorney so that helps you remember her first name. so we can use these memories. and that is an emotional memory because if you've ever been sued. just like the three b's over my car i was stung by a bee so i
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can remember that. we can use these methods to remember errands. so say i'm running out of the house and i had to remember to get eggs and pickup my dry cleaning. and i see myself holding egg, slips and the yoke gets all of my pants and i have to remember to go to the cleaners. so you can remember unrelated words. using this method. so want you to prove it to yourself, here are eight unrelated words. create a mental image for each word and then link them together by developing a story. the words can be in any order. so, take a look at the moment to look at the words i will be continued. each time a professor, horse, teddy bear, cigar, none, palm tree, pasta. maybe i will ask for a volunteer in a moment. so while you are stressing out about your story, let's talk about stress because it is not good for your brain.
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turns out animals under chronic stress actually have molar memory centers in their brain. if you inject a human volunteer with a stress hormone cortisol, they are temporary memory ã good news is we can manage stress better. meditation, tai chi, vacations, spending time with friends and family.this can lower stress levels. it not only improves mood, it improves memory. it actually alters your neural function. that you say lay in our division helen has done studies with she looks at brain function after people have done medication for tai chi. and you can see these colored areas on the mri scan show you where there's alterations and activity. in fact she and others have studied ãthese are the tips of our chromosomes. it turns out the markers of how long they are determines your life expectancy.
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so this kind of activity cannot only improve your brain health but help you live better and longer. food is very important when it comes to how well our brains age. and number one is portion control. we have an epidemic of obesity and overweight which increases the risk for alzheimer's disease. did i mention fish, anti-inflammatory. if you do not like fish, you can try nuts, walnuts are very potent and omega-3 anti-inflammatories. if you are alerted to not sprinkle some flaxseed on your cereals. you will get an omega-3 boost. fruits and vegetables, most of us do not get enough roots and vegetables. they are antioxidants. our brains age and there is oxidative stress. and blueberries when they're on sale, a great. freeze them, they maintain their potency in the freezer. a great antioxidants not.
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finally we want to minimize refined sugars and processed foods. chips, dessert and so forth. it doubles your risk for alzheimer's disease. we have a challenge when it comes to nutrition and brain health. if you look the evolution of it we are going in a certain direction. [laughter] the bad news is that obesity and overweight, actually obesity quadruples your risk of alzheimer's. but the good news, they have been doing studies of obese individuals and they find when they lose weight, and memory abilities return. and in a matter of months they follow these people and they are sustained benefits over the years. but it is a challenge. and neuroscientists have looked at what was on the brain when we are trying to resist the
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cookies and crackers and you see some of the brain areas in the frontal lobe that are controlling his impulses. so this one part of my brain, it tells me when i see that second piece of chocolate cake, do not eat it. there is another part right here that is saying, eat the cake, eat the cake.it is like a battle. the good news is, if we can resist initially, our neural circuits actually change. so through our own willpower we can rewire our brain and it gets easier. all of us know that we are going on a diet for healthy program is hard to change the habits initially. but over time it gets easier. now there is good news on the nutrition side. it turns out that alcohol in moderation is associated with better brain health. i hear since she was in the back. but then there is also questionable how much is one glass of wine? we are not sure why it works. it may be that having a glass of wine at dinner relaxes us.
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and that helps us with brain health. it could be chemicals in the wind. one chemical is called reserve a troll. it is antiaging and so scientists have extracted it out of the red wine and put into capsules and now they are testing it. ... it's endureyed food. in india, they consume a lot of 0 spicy food and have a lower rate of
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alzheimer's, and it's antiinfamiliar terrorry. people who eat indian foodmer frequently perform bert on memory tests. so, what else can we do in a-lo another other things. you want to avoid head trauma. that's not good for the brain. anybody who has hit their head and lost consciousness for an hour or more, doubles the riecks for alzheimer's. you want to stop smoking if you smoke. not good for your brain. stay positive. keeping a positive outlook helps us live longer, better and helps our brain health, and then finally, get a good doctor. listen to your doctor.
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simple things. high blood pressure, high cholesterol, just taking your medicine for those problems will improve your brain health and also help you live longer. now, question often comes up, can we prevent also alzheimer's? and if you think of prevention as equivalent to cure, the answer is no. with we think of prevention as staving off decline or delaying the onset of symptoms, i think the answer is yes. there have been a number of studies showing that some of the strategies, physical exercise, heating a healthy diet, reducing stress, can make a difference. and can delay onset of symptoms by years. and we have done studies showing there's an adid difficult. -- additive effect, if you do one thing, it's good.
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two things, it's better. so a sed den e den tear life and -- sed sedentary lifestyle but i would living a braining are healthy strategy you can delay onset of symptoms by many years and that can be very meaningful. so, the issue is how to help people change. when people come to see me ucla, dry the standard medical approach and ask check about their diet, i want you to eat this and exercise, and often the response is, well, doc, don't you have a pill? so it's hard to change. i think there's a formula to this there are things we do. we have tried to integrate that into our books. i saw "your pow bus my wife is a co-author and she -- if it weren't for gigi, the books would have four sections. introduction, methods, results, and discussion and no one would
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read it. you have to milwaukee the information alaska -- make the information accessible so the first step is helping people understand the connection between brain health and behavior. if we understood that, we're more likely to make the right decisions. we also need to create programs that are fun and easy. my latest bike cawed "two weeks to a younger brain." if called it two years to a younger brain no one would buy it. but we cans is enough time to take baby steps and introduce yourself to these strategies and enough time so you start seeing results and experiencing rules and feel better. that is what motivates people for the long haul. so what about the future? where-we going? one thing that we're looking at that ucla is trying to again,
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look at incentives to get people to engage in these sorts of programs. the have been studies looking at these modifiable risk factors, for dementia and they have a huge impact. one study found that up to half of all alzheimer cases worldwide could be attributable to these factors oneside we call the ucla also home pleaser description project and -- alzheimer prescription project and recruiting people from the electronic record getting them on a four hour per leave healthy lifestyle program and is unexpensive. we have a control group group. we apt 0 show the programs save the health system dollars and then we can export it and motivate people in that way through their health system.
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so, anybody want to volunteer their story? here's a brave woman. i want to hear the story. i want to hear your -- wait. why don't you tell me the story and i'll repeat it. [inaudible] >> the professor sitting on the beach, written a story, carrying a teddy bear. [applause] >> so, the professor met a nun smoking a cigar who was eating pasta under the palm the. that did deserve hand. a fantastic story. [inaudible] >> i just have a question. the nun -- hold on. the nun was smoking the cigar? >> y. >> did you good to catholic
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school? you can have a lot of fun with these kinds of approaches. our, ucla longevity center. how do you deal with names and faces? who is this? >> harry. >> very good. i think i heard a mona. no? not a perfect system but that's quite good. and oh this? oh. you know everybody said sue bangle. so, it's clear there's a lot we can do to keep our brains healthy as we age. while we're waiting for science to catch up we can eat right, exercise, keep minds nimble, try to control stress. the longevity center has a lot of programs in area. we have maplery maintenance, we have memory training. we're actually licensing these
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programs all over the country. we're now in canada and starting out in china. so there's tremendous interest in understanding and helping people live better longer. if you want to get an additional brain exercise, just google us. ucla longevity center. you have much more control in keeping power brain halvey. thank you so much. i'm going to be tout -- i can't take questions here put i will be signing books. please join me for more conversation the book signing. >> ladies and gentlemen, if you're leaving back and coming back, please use the single door to your right. thank you.

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